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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for heel spurs and plantar fasciitis in the feet

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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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Posted on Sat, 11 Mar 2017 in Bones, Muscles and Joints
Question: Hi. I have been diagnosed with mild heel Spurs and Plantar Facitious in both feet after X-rays and exam by Orthopedic surgeon. These heel and foot symptoms have been going on for approximately 6 months. I have tried exercises, which seem to aggravate rather than help. I have bought numerous pairs of shoes to help, and put several types of ortho inserts in good leather shoes. I have used ice treatments, rest, and bandaging my right foot especially with wide wrap tape, rather like an ace bandage. I even got Cortisone shoots in my heels in late November. To make bad matters worse, I caught my right toe under a puppy gate and fell. I sprained something or must have a stress fracture. I have used Tramadol, Ibuprofen for inflammation, etc. Nothing seems to really stop the pain. It is not constantly bad, but worse in the morning and evening generally, or after periods of long standing or sitting. This makes walking very difficult and painful. Other than this, my health is good. I can not do the normal everyday things like vacuuming without pain. This came on me suddenly, and will not go away. I have tried everything I know except perhaps accupuncture or a Podiartrist or Chiropractor. Please, do you have any advice or suggestions for me. I also tried compression socks. That and taping my feet seems most helpful. I have a 8 day cruise coming up and have to rush through an airport. I am at a loss. Help. XXXX
doctor
Answered by Dr. Mahaveer Patil 41 minutes later
Brief Answer:
check uric acid levels

Detailed Answer:
Hi,

Thank you for posting the question.
I have gone through your medical history in detail.

Actually,in such cases,local steroid injection shots should be very effective ,provided they are given properly at the exact site under Xray / C-arm control guidance.

If even this is not helping,then you should get your blood uric acid levels checked.
If these levels are raised,then uric acid lowering medicines will provide relief from pain.

Recently,bone marrow plasma injections at the painful site are being given with great results.

You can talk to your doctor regarding this.

Avoid taking pain killers for prolonged periods of time.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Mahaveer Patil 49 minutes later
Should I go back to my Ortho Dr. for the blood uric acid levels test, or just a GP? Also do you suggest oral Prednisone therapy in addition to possible bone marrow plasma injections? The steroid injections in my heels were so painful and seemed to provide little relief. Do you think there is something else going on besides Plantar Fascitis. I have had trouble with that in the past, when I was still teaching, but the pain was only in one heel and never this difficult to manage. Give me your best opinion. Thank you very much. I will take your advice.
doctor
Answered by Dr. Mahaveer Patil 5 minutes later
Brief Answer:
Query answered

Detailed Answer:
Yes,you should go back to the ortho doctor and get uric acid levels checked.

Oral prednisolone should preferably be avoided due to its known serious side effects.
Instead,tablets containing bromelain,rutoside,trypsin,chymotrypsin should help.


Apart from plantar fascitis,Gout (raised uric acid levels) or calcium deposits in the plantar fascia are the other possibilities.

LASER therapy is also known to give better results.You can talk to your doctor about this.

For me the best option is taking a local steroid injection once again under proper Xray / Carm guidance. Blindly given injections usually miss the target and give more pain than relief. So ,we,at our clinic give precisely directed steroid injections under Carm guidance with excellent results.

3 injections at 3 weeks interval each should give the best results.

Reducing body weight ( if you are obese) should be done at the earliest.

Continue wearing soft heel cushions.

Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mahaveer Patil 28 minutes later
Thank you for your advice and expertise. Best regards. XXXXXXX Denning
doctor
Answered by Dr. Mahaveer Patil 1 hour later
Brief Answer:
welcome

Detailed Answer:
You are always welcome for any further questions / doubts.

Thank you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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